Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

199 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

I am scared, My breathing is getting worse?

I have Dilated Cardiomyopathy. My ejection fraction was 45%, but now it is just above 30%. These past few weeks my breathing has got worse, and I have had an increase in chest pains. My husband says go to the doctor but all she says is it is part of what I have. I am already on two types of medication for my heart Ramipril, and Carvedilol. I have been told that I will die from this, and it could be at anythime. But when I woke up today, I had been asleep for nearly 18 hrs due to tiredness, and I am unable to get out of bed because when I move around I really struggle to breathe. I live in the UK, and I was wondering if there is any other form of treatment I could try instead of/or as well as Ramipril and Carvedilol. If anyone can help I would eternally greatful. Please only serious answers. Thank you.
Wed, 16 Dec 2009
Report Abuse
Question is related to
Diseases and Conditions ,   ,   ,  
Drug/Medication
Lab Tests
  User's Response
's  Response
From what you wrote, I have the sense that this has been a gradual increase in respiratory effort with activity. Nobody likes to go to the ER unless they have to. To help you decide whether this is something to go to the ER or whether this is something that can be addressed more routinely, answer the following: 1. Have you gained 5 or more lbs over the last week? 2. Are you more short of breath with laying flat - has this worsened over the last week? 3. Are your swollen - usually at the ankles? 4. Has there been a sudden increase in your shortness of breath over the last week? If you answered yes to at least two of the above questions, go to the ER, you are in congestive failure and need to be diuresed. (get the extra fluid out of your body) If you answered yes to one of the questions - if you feel like you are in respiratory distress, proceed. If you answered yes to none of the above questions, then you are probably fine to wait and be seen more routinely. Of course, if things change while waiting - proceed. From what you've written, I do have some suggestions to consider regarding your therapy - which was your original question. 1. Add Spironolcatone. (improves remodeling) 2. Add Lasix (reduces congestive symptoms - primarily a comfort step) 3. Add an ARB (example Losartan) in addition to your ACE inhibitor (Rampiril) medication. (improves remodeling) 4. Increase the dose of the Carvediol up to 25mg two times per day. (improves remodeling) 5. Add Digoxin. (improves contractility) 6. Consider cardiac resynchronization therapy via a biventricular pacemaker which can be useful with certain patients. You may also qualify for consideration of an ICD (defibrillator) per the MADIT 2 criteria. 7. Evaluate and ideally manage any other processes that might be effecting your cardiac function - sleep apnea, valve function (especially mitral valve), diabetes, hypertension are all examples that can negatively effect your condition. Discuss these measures with your physician. They all have medical literature behind them endorsing their use. I of course would not do everything at once, but you have some options about where to go. If your physician discounts additional changes then I might request a referral to speak with a specialist. I hope this is helpful. Good luck.
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer. For a more detailed, immediate answer, try our premium service [Sample answer]
Share on
 

Related questions you may be interested in

doctor1 MD

hi I have been having shortness of breathe , feeling something in my esophagus when I swallow, its difficult to take deep breathes, I did have a spot of chest pain but that s gone now.. I did inhale some nasty chemicals.. but this has been goin on for about a month now and its not getting better or worse. I don t wheeze high pitched sounds although I was for a day or two , two weeks ago.. theres just a weird sound when I breathe and yes I do smoke.

doctor1 MD

Hi. I have been having shortness of breath, and sometimes a high pitched squealing when I breath out. I have skipped heart beat (my family physician says are extra pvc s) but I also have a lot of chest pain on the left side of my chest chest. I can also feel my heartbeat extremely hard under my left breast. I m getting pretty scared, because it has been going on for a few months and keeps getting worse.

doctor1 MD

I have been having shortness of breath went to lung specialist.. Did test.. A little damage to lungs from smoking.. I do not smoke now... Had ct scan... Found 4 nodials and test said usually for size and shape is benign.. Another ct in a year... I use a daily inhaler and have a emergency inhaler.. Now for my problem that is really concerning me... Fatique.. Shortness of breath.. Wheezing.. Some congestion.... If I have my arms up and walking.. I get really short of breath.. Where I have to use my emergency inhaler.. Scares me and I know that makes it worse.. But it is strange that I get bad with my arms involved.. Could this be my heart?..

Recent questions on  Cardiovascular disease

doctor1 MD

My husband's heart is beating loudly and seems to be beating irregularly. I took his blood pressure and it was normal. His heart rate was 102bpm. He also has an urge to cough periodically. He's had these episodes happen before and the cough has helped at times. Do we need to be concerned? His father died from heart disease and started having an irregular heart beat when he was 35.

doctor1 MD

Recently I have been experiencing a "racing heart" ulse rate upwards to 111, and general tiredness. Is this something to be concerned about since heart disease runs in my family, including a sibling that died from a heat attack at age 57. My age is 56

doctor1 MD

5'6" 175lbs in great shape. I run and walk and weight train. my heart started to "stutter" about 4 or 5 days ago and is increasing in occurence. sometimes multiple stutters. 47 years old. no history of heart disease. low cholesterol levels. low blood pressure.

doctor1 MD

l am a 51yrs old sudanese schoolteacher 5 ft six inches of height 55kgs weight diagnoesd in Kuwait chest hospital in 1989 as a vsd sevesre pulmonary hypertension and not indicated for surgery i got married in 1998 with three duaghters 12_10_8 .l know my case very well and l ve heart disease history a younger brother had died of heart failure and four youger brothers died in their baby hood they were likely have the same disease .my parents are close relatives and they still alive with reasnable health according to thier age.l was hospitalised in1986and 2006 for haemoptasis. I have been suffering recently from feet swelling and neck and shoulders stiffness specially when l carry any something over ten kilos of weight accompanied with a high fever and l feel the area very hot a two days ago echo showed that the case is normal a chest xray showed in the day that heart is not enlarged but not in good health other lab results 2days ago esr 8 mm/h.hb119.5percent uricacid 6.0 my question is what are the exepected symptoms and comlications in this case and how to deal with them.email: YYYY@YYYY cell 0000

doctor1 MD

How do I help my wife of 40 + years who has developed dementia in the last two, getting worse all the time: memory, mood etc. I try to do everything I can for her but she does not cooperate a good share of the time. She sits in a recliner all day...

doctor1 MD

i lack vitamin D & Vitamin B12 .how manage this two naturally ?

doctor1 MD

I had completed my routine blood check up 5 days back, I have attached my report. Please review my report & let me know on the actions that need to be taken, am currently consuming 125 mg of thyroxine